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Pregnancy Spotting Questions and Answers

I am a mother of two and a biochemist with a degree in biology who has gone through the experience of a tubal pregnancy.

Worried about spotting? Here are common questions and answers to what causes spotting and bleeding in both early and late pregnancy.

Worried about spotting? Here are common questions and answers to what causes spotting and bleeding in both early and late pregnancy.

Is It Normal to Spot During Pregnancy?

Up to 33% of pregnant mothers will experience slight bleeding during the first 2-3 months of their pregnancy. This slight bleeding is known as "spotting." Sometimes, the spotting is due to the implantation of the embryo into the uterine lining. Unfortunately, sometimes bleeding does indicate an impending miscarriage.

50% of women who have some bleeding in early pregnancy will go on to have healthy babies. The remaining 50%, unfortunately, will proceed to miscarry. Signs of abnormal bleeding in early pregnancy include heavy bleeding, blood that contains tissue and clots, or bleeding with painful cramps. Women should report all bleeding or spotting to their obstetrician, so that appropriate monitoring, ultrasounds, and blood work may be completed.

Talk to Your Doctor

Spotting in pregnancy should always be reported to your healthcare provider. Signs of an impending miscarriage include the loss of pregnancy symptoms, cramping and bleeding, or the passage of clots. A physician will be able to perform some simple blood work and an ultrasound to determine if the pregnancy is viable, or if a miscarriage will occur.

Worried About Spotting in Pregnancy

It is normal to be anxious over bleeding in pregnancy. Consult your doctor for any spotting  - 50% of pregnancies with early spotting proceed normally, while the remainder end in miscarriage.

It is normal to be anxious over bleeding in pregnancy. Consult your doctor for any spotting - 50% of pregnancies with early spotting proceed normally, while the remainder end in miscarriage.

What Causes Spotting During Early Pregnancy?

There are several normal events in early pregnancy that may trigger some spotting.

  • Implantation bleeding may cause some pink or brown discharge as the embryo embeds itself into the uterine lining. This spotting may cause a few streaks of bloody discharge, but will not resemble a menstrual period in any way. Significant amounts of bright red blood should be mentioned to an obstetrician immediately. Implantation bleeding occurs approximately six days after the egg has been fertilized.
  • Spotting may occur after a couple has engaged in sexual relations, as the cervix has an increased blood supply.

Sometimes spotting does indicate an impending problem in a pregnancy, particularly if the scant amount of bloody discharge turns into frank bleeding. A woman should contact her health professional immediately if there is heavy bleeding, significant cramping, or the passage of clots. Abnormal causes of bleeding in pregnancy include:

  • An impending miscarriage. Early miscarriages are usually caused by genetic problems in an early embryo, though other causes (like low progesterone) may also be at play.
  • A completed miscarriage. In this scenario, the miscarriage has happened and an obstetrician should be contacted to determine if a procedure called a D&C is required.
  • Ectopic pregnancy. This pregnancy is usually accompanied by severe pain and is a medical emergency. A doctor's ultrasound will reveal the location of the implanted embryo: if the embryo has implanted in the Fallopian tube, abdomen, or any location other than the uterus, the pregnancy is considered ectopic.
  • Blighted ovum. An ultrasound will show a sac, but no embryo. This is sometimes called a "missed miscarriage," as the woman may begin to spot several weeks into her pregnancy. Most blighted ova are caused by genetic defects.

Placenta Previa

Placenta previa may cause bleeding during late pregnancy. Women should receive an ultrasound during the second trimester to identify this condition.

Placenta previa may cause bleeding during late pregnancy. Women should receive an ultrasound during the second trimester to identify this condition.

What Causes Bleeding During Late Pregnancy?

Bleeding in the second and third trimesters is a medical emergency. There is no routine cause for bleeding in the third trimester - a woman experiencing frank bleeding should get to the nearest emergency room and call her obstetrician. The causes for bleeding in late pregnancy are different from bleeding observed in early pregnancy. The following conditions can cause bleeding in the third trimester:

  • Vasa Previa: in rare cases, a baby's umbilical cord will lie over the cervix, because the cord has attached to the baby's amniotic sac rather than the placenta. This can cause the blood vessels in the umbilical cord to rupture.
  • Placenta Previa: in normal pregnancies, the placenta is high in the uterus and safely away from the birth canal. In placenta previa, the placenta covers the cervix and heavy bleeding will occur when the cervix starts to dilate and efface. Most babies with placenta previa will need to be delivered by Caesarian Section.
  • Placental Abruption: the placenta is normally firmly attached to the uterine wall until after the baby is born, when it detaches and is delivered as the after-birth. In some women, the placenta begins to detach prematurely, causing bleeding. A woman with a premature placental abruption will often be placed on bed rest and will be monitored very closely for the remainder of her pregnancy.
  • Rupture of the uterus: this serious condition is caused when the uterus literally rips apart, and the baby is ejected from the womb into the abdomen. A woman is at higher risk of uterine rupture if she has had more than four pregnancies or prior surgery involving the uterus (including prior Caesarean Section).

Spotting in Pregnancy: A Poll

Is Cramping Normal in Early Pregnancy?

Cramping during early pregnancy is often normal, as the uterus expands and the embryo implants into the uterine wall. As long as the cramping is slight and not accompanied by bleeding, it is likely normal. Report any cramping to a healthcare professional, as sometimes cramping can be a sign of a serious problem.

Causes of cramping in early pregnancy may include:

  • Round ligament pain - the ligaments suspending the uterus are stretched and pulled as the uterus grows.
  • Implantation of the embryo.
  • Ovarian cysts.
  • Miscarriage (if accompanied with bleeding).

Cramping with bleeding is not normal and should be reported immediately.

What is a Threatened Miscarriage?

A threatened miscarriage is diagnosed if there is bleeding in early pregnancy, but the cervix remains closed and the gestational sac (or embryo) is still visible on ultrasound. A threatened miscarriage does not mean that a miscarriage will definitely occur. It simply implies that there is an increased likelihood for a miscarriage.

A physician may order a blood test to check for beta hCG levels, which should double every 48-72 hours. If the hCG levels are increasing at the proper rate, the likelihood of a miscarriage is reduced. hCG levels that stagnate or fall, however, indicate a failing pregnancy.

Empty Gestational Sac

An ultrasound may show an empty gestational sac, which means a miscarriage will occur.

An ultrasound may show an empty gestational sac, which means a miscarriage will occur.

What is an Impending Miscarriage?

Bleeding and cramps accompanied by an open cervix generally indicate an impending miscarriage. This means that miscarriage is unavoidable, and will happen in the near future.

Women may opt to miscarry naturally, or have a procedure called dilation and curettage (D&C) performed. With a D&C, the physician dilates the cervix and manually removes any remaining tissue from the miscarriage. Most D&C's are carried out under general anesthesia, though some are performed with local anesthetic only.

Is Spotting During Pregnancy Normal?

What is an Incomplete Miscarriage?

In an incomplete miscarriage, some of the fetal tissue is expelled from the womb. Some of the tissue remains behind, and can cause a bleeding and infection risk. Women who have had an incomplete miscarriage will generally require a D&C to remove all tissue from the uterus.

A related condition, a "missed miscarriage," causes no spotting or bleeding. The embryo does not develop or dies in the womb, but is not miscarried. The death is generally found on a first trimester ultrasound. The lack of a heart beat after a certain gestational age (approximately 6 - 7 weeks, allowing for varying conception times) is usually the defining feature. Sometimes there is a blighted ovum, where the egg was fertilized but never developed an embryo at all - only an empty sac will be visualized via ultrasound.

Antibiotics may be required to prevent infection after the procedure is carried out.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

Question: I'm 8 weeks pregnant. I had my ultrasound done yesterday. My doctor is saying everything is fine in the report, but I'm having spotting daily. My doctor has asked me to rest . Can you please tell me why this is happening?

Answer: I am glad your physician has reassured you that all is well. There are many reasons for spotting in early pregnancy, including low progesterone levels, an irritated cervix, and implantation bleeding. I would follow your doctor's advice and get plenty of rest. Be sure to follow up with regular appointments so your pregnancy can be monitored and any potential issues addressed right away.

Question: Could I still be pregnant after bleeding for five days before my cycle?

Answer: Bleeding does not preclude pregnancy. You may be pregnant even though you have been bleeding prior to your cycle. If you are concerned about a potential pregnancy, wait about a week until after your original cycle due date and take an at-home pregnancy test. If you would like to know sooner, contact your OB/GYN and have a blood test ordered for beta hCG, which can detect minute concentrations of the pregnancy hormone and can give you an answer earlier than a urine-based home pregnancy test.

Question: I am pregnant. After my ultrasound I learned that the developed Gestational sac is on the left side of uterus. My Doctor said if it doesn't shift to the center center within week we will have to remove it because it may damage to the uterus. My beta HCG level is more than 7500. Do you have any advice?

Answer: It sounds like your doctor is concerned about a pregnancy occurring in the tubal interstitium, which is when a pregnancy implants in the area where the fallopian tubes join the uterus. Your physician may also be concerned about an angular pregnancy, which displaces the round ligament. I would call your physician to make an appointment to explain and clarify the concerns and risks about this pregnancy. The beta hCG levels are less important than the full clinical picture, which can only be determined through a thorough examination by your physician.

Question: Is spotting compulsory for every woman?

Answer: Not every woman will experience spotting in pregnancy, but it is fairly common in the earliest stages of pregnancy. Implantation is a frequent cause of spotting in early pregnancy. Many women never experience any spotting at all, and this is also normal.

Question: I have been spotting for more than a week and I missed my period last month. I went to the doctor and he said I should do an ultrasound. What could be the cause of the spotting?

Answer: You haven't stated whether or not you have had a pregnancy test to determine if you are pregnant, but there are two early tests done to try to determine the health of a very early pregnancy. One test is an ultrasound to determine the location of the pregnancy (making sure the embryo implanted into the womb) and another test is for beta hCG levels, to ensure the "pregnancy hormone" levels are rising at the expected rate. There are many causes for spotting in early pregnancy, and determining the reason for spotting in your particular case will require a work-up from your physician. An ultrasound is a common diagnostic tool used in early pregnancy.

Question: How long does spotting or light bleeding last in early pregnancy?

Answer: Spotting typically resolves by 9 or 10 weeks. As in all cases of bleeding with pregnancy, a physician should examine and diagnose the cause of the spotting.

Question: I am roughly 7 weeks pregnant, with moderate bleeding. I’m using pantyliners and those have very little blood. I’m not having cramps, or any fever or pain. Is some bleeding normal at 7 weeks of pregnancy? I haven’t had my first appointment yet. I am very worried.

Answer: I would call your OB/GYN and make an appointment as soon as possible (most doctors will leave spots open for emergency appointments). The only way to verify your health (and the health of the pregnancy) is to have a thorough physical exam done by a qualified medical professional. They will be able to draw blood to take a quantitative beta HCG test (to determine how much pregnancy hormone you are producing) and will do an ultrasound to verify the date and health of your pregnancy.


Maro on May 15, 2020:

I am 8 weeks pregnant and I have light bleeding just for a sec before that around week 6 it was the same is this normal?

Leah Lefler (author) from Western New York on May 03, 2019:

My heart goes out to you, Tints. It is very stressful to have spotting in early pregnancy. Sometimes it is simply due to an irritated cervix and everything will proceed normally, but sometimes it does mean a miscarriage may be imminent. Unfortunately, the only way to tell at this point is to rest and wait. I have had spotting with my two healthy pregnancies, but then also had spotting (followed by frank blood) with one miscarriage and then two ectopic pregnancies. The spotting with my healthy pregnancies became very light and stopped by 8 weeks of pregnancy, and my miscarriage/ecoptics had an increase in bleeding over time. I would follow your doctor's advice and get as much rest as possible and ensure you have frequent follow-up visits.

Tints on May 01, 2019:

Hi..I am 7 weeks pregnant,and I've been spotting for 3 days now,just today I noticed stringy bits of blood,my scan showed my internal os is slightly open,my Dr said I rest for 3 days..but am Soo worried..will my pregnancy proceed

Leah Lefler (author) from Western New York on September 23, 2018:

Hi Deondra - some pregnancies experience spotting in the early weeks. This can be caused by implantation and can be entirely normal. Sometimes, however, an unexpected complication can create a medical situation that needs immediate attention by a professional. With your bleeding and severe headaches, I would contact your OB/GYN and tell them you have a positive pregnancy test along with bleeding and severe headaches. They should be able to fit you in immediately for an "emergency appointment." If they cannot, I suggest going to urgent care to have a work-up done to make sure everything is as expected for this stage of pregnancy. I hope you keep us updated on your situation, and I am sending many positive thoughts that all is well!

Deondra Gripper on September 21, 2018:

I'm confused on this pregnancy because my cycle was last on August 23 I had unpertected sex on the 1st through the 3rd witch was right and I took 5 test on the 18th and the were all positive but faint and then I started bleeding 5 days before my accual period and then it stopped it was only for 3 days and then after those 3 days I had stickey dark brown slime the whole day when I wiped only and then after that it was pink but that's when later when I went to the bathroom I started the bleeding now I'm having bad headaches and fall asleep while watching a movie can't stop urinating still positive test but darker what should I do

Kernisha on December 23, 2017:

have anybody else had implantation bleeding and how long did it last ??? I think I had it... it was dark red with pink tint to it but in my pad it looked black but when I wiped it was red with pink tint in it and only lasted a couple of hours and went away...the next day it was gone completely ... when it was going away it turned pink...could I have had it.

Leah Lefler (author) from Western New York on September 22, 2013:

Hi Tam3, I would call your doctor and request a beta hCG test. This test measures the quantity of hCG (the pregnancy hormone) and by monitoring how fast the hormone is rising, they can tell you how likely your pregnancy is to continue. It is so very frightening - sometimes spotting happens with a healthy pregnancy, and sometimes it is a signal of an impending miscarriage. The best thing to do at this point is to call your doctor to get more information. I have had four pregnancies - all of them had spotting. I have had two babies and two spotting can mean something sinister, or it can be OK in the long run. Brown blood is old blood, so I wouldn't be as concerned about it - but if it turns bright red and you continue cramping, call your doctor or go to the emergency room.

tam3 on September 18, 2013:

I need help. I am 4 days late today with my period. Both home test n doctors show a weak positive. Js after the doctors visit yesterday I started cramping n bleeding. Blood looks brownish could be I having a miscarriage?

Leah Lefler (author) from Western New York on September 30, 2012:

We enjoy life so much with our children. They are curious, smart, and funny - they make so many things in life extra joyful, Pauline. We are so lucky to have them!

Leah Lefler (author) from Western New York on September 30, 2012:

Losing a child is an absolute tragedy. Every baby is a miracle, Hyphenbird - every child born is amazing. Miscarriage is sadly common, but most women will go on to have a healthy pregnancy after a miscarriage.

Pauline Davenport from Isle of Man on September 30, 2012:

They surely are, and they bring so much love into the world and each one has so much wonderful poiential in the making, so much everything. the wonder of them is totally awesome

Brenda Barnes from America-Broken But Still Beautiful on September 30, 2012:

Leahlefler, this Hub made me cry for the mothers who lose babies and smile for the ones who have healthy babies. Your article answers so many questions that pregnant women have. I can just visualize a frightened and anxious woman getting on the internet and finding this. It will help them tremendously.

As you know, I am a senior citizen so pregnancy is not in my future (unless God does another Sarah miracle!) but I well remember my time of carrying my only child. They are miracles in the making. Thanks so very much, Hyphenbird.

Leah Lefler (author) from Western New York on September 29, 2012:

Thank you, teaches! All spotting should definitely be reported to a woman's doctor. There are many cases of successful pregnancies when there is spotting early on. Sometimes there is a miscarriage, and unfortunately there is nothing anyone can do to stop that from happening once it has started. I have had three pregnancies, all with spotting. Two resulted in healthy children, and one was a miscarriage.

Dianna Mendez on September 29, 2012:

This is a very good topic to share with young women who are pregnant or trying to get pregnant. Knowing what to expect or what to avoid is important and also helps to calm unexpected fears from spotting. Very well done, researched and written. Voted way up, Leah!

Leah Lefler (author) from Western New York on September 29, 2012:

I have two beautiful boys, Pauline, and they are the light of my life. There is absolutely nothing better than the magic in a child's eyes. My children are five and six years old. I have had a miscarriage as well- though the presence of my two boys definitely shows that a healthy pregnancy is often the outcome when there is some spotting in pregnancy.

Pauline Davenport from Isle of Man on September 29, 2012:

Bless you we can't and thank you. Oh we get terrified when we're pregnant don't we, especially when we think something could be wrong? How lovely to have a little lad - six is a lovely age- he must fill up your heart.

Leah Lefler (author) from Western New York on September 29, 2012:

A new baby is so exciting, Pauline! I once had dental work performed before I knew I was pregnant, and I was terrified the local anesthesia would cause problems with the baby once the pregnancy test came back with a +. Fortunately, everything was just fine and my son is six years old today.

I hope your daughter has an uneventful remainder of her pregnancy! Congratulations on your new little granddaughter - I bet you can't wait until she arrives!

Pauline Davenport from Isle of Man on September 29, 2012:

Very timely and informative here for us here with a new baby on the way!!! My daughter didn't know she was pregnant until she was scanned for abnormal , very painful, joint pains and it was discovered that she was pregnant. Thankfully she is now well on with her pregnancy and at her 20 week scan everything was seen to be normal and well, and we are all excited about our new little girl, due to be born in February.

Thanks for this leahlefller. It's so good to have the knowledge to able to look out for them both properly. Voted up, useful and interesting

Leah Lefler (author) from Western New York on September 28, 2012:

I had some cramps and spotting with both of my sons, Emma - it only lasted a day for each boy and wasn't very significant. Fortunately, they were both brought to term and are five and six now. I recently had a miscarriage and there was heavy bleeding and cramping - very different from the light "spotting" I had with my first two.

Leah Lefler (author) from Western New York on September 28, 2012:

Thanks, Keeley. I recently had a first trimester miscarriage, and there was cramping and bleeding. I had spotting with my first two pregnancies, and delivered two healthy babies. Most first trimester losses are due to genetic problems with the embryo, and it simply can't develop.

Emma Kisby from Berkshire, UK on September 28, 2012:

I can remember having cramps and spotting when I was pregnant with my son. I didn't know I was pregnant, so put it down to being a light period. I never thought to tell my doctor after I found out I was actually pregnant.

We are not always aware of these things - thanks for bringing it to light Leah.

Keeley Shea from Norwich, CT on September 28, 2012:

A very informative hub. I have had experience with miscarriage myself. I didn't have any bleeding when I was pregnant with that child. However, I did have spotting with another pregnancy when I was 23 weeks pregnant. I was put on bed rest until it stopped (which took 2 weeks - it was very light, but it took that long to completely stop), but I went on to have a very healthy baby boy who is now almost 6 years old! Great Hub - VERY WELL WRITTEN!!!!